Applying a Virtual Art Therapy System Based on the Michelangelo Effect in Patients with Spinal Cord Injury

Highlights: What are the main findings? High scores in terms of USEQ and NASA were reported for the proposed Virtual Art Therapy System both for patients and healthy subjects. It can be administered in patients with spinal cord injury for the rehabilitation of their upper limbs. Most of the kinematic variables automatically measured by the system were significantly different between patients and healthy subjects. Analysis in the frequency domain of subjects’ movements showed a high horizontal (but not vertical) variability in the spectrum. What is the implication of the main finding? Virtual Art Therapy System is a comfortable and user-friendly technique for administering upper-limb therapy in patients with spinal cord injury. The System also provides quantitative measures of the kinematic parameters of patients that are helpful in assessing patients’ deficits and performances. The spectral analysis could be helpful for verifying the match between the rehabilitation aims and the task executions. Background: Serious videogames have already demonstrated their positive impact on rehabilitation and of particular interest is the virtual reality (VR) technology. This immersive technology has been used in this study to create a neuroaesthetic experience based on the Michelangelo effect for the rehabilitation of patients with spinal cord injury. The aim of this study was to test the usability of a system for virtual art therapy and its capacity to assess patients’ deficits performances. Methods: A VR headset was worn by the participants who experienced a painting simulation of famous artworks (artistic stimuli) against a coloring canvas (non-artistic stimuli). The trajectories of the hand were studied to obtain different kinematic and spectral parameters to evaluate the user performances. A total of 13 healthy subjects and 13 patients with spinal cord injury participated in this study. Results: Significative differences were obtained for most of the parameters between the two groups, except for the normalized jerk and energy of the spectrum. Analysis in the frequency domain showed that both groups preferred horizontal movements for painting the canvas. The NASA and USEQ scores reported a comfortable and user-friendly system according to the patients’ point of view. Conclusions: The system can be a usable tool, the rehabilitative efficacy of which should be tested in patients with spinal cord injury. The kinematic and spectral parameters would allow for the evaluation of the performances alongside the clinical scales, distinguish pathological and physiological performances.